Our mission: We advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time.

Our vision: Achieve the healthiest population possible, leading the transformation of health care in our region and setting the standard for our nation.

DHMC is located on a 225-acre campus in the heart of the Upper Connecticut River Valley, in Lebanon, New Hampshire.

DHMC is made up of:
• Mary Hitchcock Memorial Hospital
• The Dartmouth-Hitchcock Clinic (a network of more than 900 primary and specialty care physicians located throughout New Hampshire and Vermont)
• Dartmouth Medical School
• Veterans Affairs Regional Medical and Office Center in White River Junction, VT.

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Antidepressant Therapy for Functional Dyspepsia

We propose to investigate whether antidepressant medications are efficacious in functional dyspepsia. The prescription of antidepressants to treat functional dyspepsia is based on three propositions. First, antidepressants could reduce the severity of co-morbid psychological symptoms, especially anxiety and depression. Second, antidepressants have central analgesic actions. Thirdly, antidepressants have been shown to have local pharmacological actions on the gut, and may specifically alter gastric emptying and fundic relaxation based on preliminary data, but the relevance of such pertubations to treatment outcome is not established.

Adult diabetic patients (ages 18-65) with gastric emptying scintigraphy-confirmed delayed gastric emptying will be recruited to participate in the study. Using double-blinded methodology, study participants will be randomly assigned to one of two treatment arms: promethazine 12.5 mg three times daily for 28 days or placebo three times daily for 28 days. The primary outcome will be the change in gastroparesis symptom severity, as measured by the Gastroparesis Cardinal Symptom Index (GCSI) at four weeks compared to baseline. Participants will be seen for a clinic evaluation at weeks 0, 2 and 4, during which symptom scores, adverse events and treatment compliance will be assessed. It is hypothesized promethazine treatment will be superior to placebo in improving symptoms of gastroparesis.